HomeMy WebLinkAboutDrain Layers Permit 190 Abbe Road TOWN OF NDSOR
DEPARTMENT CONTROL
South.: B/P No.:
ticut �.y Q �
. List No.: _ p�
DRAIN LAYER'S PERMIT Np 214
—75 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at �_� �� - ^
on the
side, between
at premises owned by lZel
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be'connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES _( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permu and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Cad Signed
Connec7/ti�on Charge Paid�/ i Licensed Drain Layer
i y
Tax Collector Issued b
Pefmit lee: jPaid $
INSPECTION: Check Number: A?
INITIAL (Sig)
FINAL (Sig)
APPROVED
(Date)
(Sig)
INSPECTOR
'`!
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